Enxerto gengival livre para correção de defeitos de tecido mole previamente a cirurgias reconstrutivas

Abstract

A anatomia do tecido mole peri-implantar é semelhante à do dente natural, uma vez que apresenta epitélio juncional e tecido conjuntivo. O selamento peri-implantar é estabelecido pela mucosa ceratinizada que previne a migração apical da margem gengival, mantendo a arquitetura tecidual e estética vermelha ao redor dos implantes osseointegráveis. O presente trabalho objetivou relatar um caso clínico de reconstrução de tecido mole previamente a cirurgia óssea reconstrutiva para a instalação de implante osseointegrável. Após a reconstrução do tecido mole observou-se que houve um satisfatório ganho de altura e espessura tecidual. Foi obtido um volume tecidual suficiente para regularização do zênite gengival e considerável volume de mucosa ceratinizada foi obtida previamente a cirurgia reconstrutiva.Descritores: Implantes Dentários; Periodontia; Reabilitação Bucal.ReferênciasMutthineni RB, Dudala RB, Ramisetty A. Esthetic root coverage with double papillary subepithelial connective tissue graft: a case report. Case Rep Dent. 2014;2014:509319.Peñarrocha MA, Carrillo C, Boronat A,Martí EM. Level of satisfaction in patients with maxillary mull-arch fixed protheses: zigomatic versus convencional implants. Int J Oral Maxillofac Implants. 2007;22(5):769-73.Ponsi J, Lahti S, Rissanen H, Oikarinen K. Change in subjective oral health after single dental implant treatment. Int J Oral Maxillofac Implants. 2011;26(3):571-77.Man Y, Wang Y, Qu Y, Wang P, Gong P. A palatal roll envelope technique for peri-implant mucosa reconstruction: a prospective case series study. Int J Oral Maxillofac Surg. 2013;42(5):660-65.Schneider D, Grunder U, Ender A, Hämmerle CH, Jung RE. Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1-year results from a prospective cohort study. Clin Oral Implants Res. 2011;22(1):28-37.Evans CD, Chen ST. Esthetic outcomes of immediate implant placements. Clin Oral Implants Res. 2008;19(1):73-80.Grover HS, Yadav A, Yadav P, Nanda P. Free gingival grafting to increase the zone of Keratinized tissue around implants. Int J Oral Implant Clinical Res. 2011;2(2):117-20.Almeida JM, Novaes VN, Faleiros PL, Macarimi VC, Bosco AF, Theodoro LH et al. Aumento de gengiva ceratinizada em mucosa peri-implantar. Rev odontol UNESP. 2012;41(5):365-69.Langer B, Langer L. Overlapped flap: a surgical modification for implant fixture installation. Int J Periodontics Restorative Dent. 1990;10(3):208-15.Raghoebar GM, Meijer HJA, van Minnen B, Vissink A. Immediate Reconstruction of Failed Implants in the Esthetic Zone Using a Flapless Technique and Autogenous Composite Tuberosity Graft. J Oral Maxillofac Surg. 2018;76(3):528-33.Chung DM, Oh TJ, Shotwell JL, Misch CE, Wang HL. Significance of keratinized mucosa in maintenance of dental implants with different surfaces. J Periodontol. 2006;77(8):1410-20.Park JC , Yang KB, Choi Y , Kim YT , Jung UW , Kim CS et al. A simple approach to preserve keratinized mucosa around implants using a pre-fabricated implant-retained stent: a report of two cases. J Periodontal Implant Sci. 2010; 40(4):194-200.Wennström JL, Bengazi F, Lekholm U. The influence of the masticatory mucosa on the peri-implant soft tissue condition. Clin Oral Implants Res. 1994;5(1):1-8. Bengazi F, Wennström JL, Lekholm U. Recession of the soft tissue margin at oral implants. A 2-year longitudinal prospective study. Clin Oral Implants Res. 1996;7(4):303-10.Bouri A Jr, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I. Width of keratinized gingiva and the health status of the supporting tissues around dental implants. Int J Oral Maxillofac Implants. 2008;23(2):323-26.Fu JH, Su CY, Wang HL. Esthetic soft tissue management for teeth and implants. J Evid Based Dent Pract. 2012;12(3 Suppl):129-42.Marquez IC. The role of keratinized tissue and attached gingiva in maintaining periodontal/peri-implant health. Gen Dent. 2004;52(1):74-9.